This application for a patient oriented research career development award will provide additional education and training for Dr. Heather Leutwyler to establish herself as a young investigator in patient-oriented research in gerontology that is focused on the improvement of mobility in older adults with schizophrenia. This K23 award will provide Dr. Leutwyler with the necessary support to accomplish the following goals: 1) design and implement a longitudinal study; 2) learn and use advanced biostatistical methods; 3) incorporate geriatric health assessment and mobility into her program of biobehavioral research; and 4) develop an independent clinical research career. To achieve these goals, Dr. Leutwyler has developed a focused program of study and assembled an outstanding mentoring team comprised of Dr. Sophia Vinogradov (primary mentor), Professor of Psychiatry at the University of California San Francisco (UCSF); Dr. Dilip Jeste (co-mentor), Distinguished Professor of Psychiatry and Neurosciences at the University of California San Diego (UCSD); Dr. Kenneth Covinsky (co-mentor), Professor of Medicine and the Edmund G. Brown Sr., Distinguished Professorship in Geriatrics at UCSF; and Dr. Bruce Miller (co-mentor), A.W. Clausen Distinguished Professor of Neurology at UCSF. Older adults with schizophrenia are a growing segment of the population yet a limited amount of evidence suggests their level of mobility is extremely poor. In order to design targeted interventions to improve the mobility of this vulnerable population, the factors that contribute to poor mobility must be understood. Limited data suggest that more severe psychiatric symptoms and poorer neurocognition have a negative impact on mobility. To better understand these relationships and how they may change over time, Dr. Leutwyler will conduct a longitudinal study of 75 older (55+) adults with SMI to: Aim 1: evaluate the relationship between neurocognitive function and mobility and how this relationship changes over time; Aim 2: evaluate the relationship between the number of schizophrenia symptoms and mobility and how this relationship changes over time; and Aim 3: evaluate the relationship between severity of schizophrenia symptoms and mobility and how this relationship changes over time. These data will lay the foundation for future NIH R01 grant applications that will include intervention studies to improve mobility in older adults with schizophrenia.